Skip to main content

Advertisement

SpringerLink
Log in

Gender differences in first episode psychosis

  • ORIGINAL PAPER
  • Published:
Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

Background

In the description of 1 episode schizophrenia patients, female gender is associated with better social function and a higher degree of compliance, while males exhibit more negative symptoms and a higher degree of abuse. The question is raised whether gender specific differences exist which should be taken into consideration in order to provide optimal treatment for the patients.

Methods and material

Data from 269 persons (181 men and 88 women), included in the Danish national schizophrenia project (DNS), were registered at inclusion and year 2, and were analyzed according to gender, social functioning, psychopathology, drug consumption and abuse during the course of 2 years treatment.

Results

Women had longer duration of illness before treatment and exhibited more affective symptoms while men were more socially isolated and had more negative symptoms. Alcohol and drug abuse appeared significantly more among men. Women were comparatively more heavily medicated than men. Social function, PANSS negative, drug consumption, affective symptomatology and abuse improved significantly after 2 years follow-up.

Conclusion

The gender differences demonstrated in the study suggest gender specific treatment interventions in order to provide optimal treatment for both male and female patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Albus M, Maier W (1995) Lack of gender differences in age at onset in familial schizophrenia. Schizophr Res 18: 51–57

    Article  PubMed  CAS  Google Scholar 

  2. Aleman A, Kahn R, Selten J-P (2003) Sex differences in the risk of schizophrenia. Evidence from meta-analysis. Arch Gen Psychiatry 60: 565–571

    Article  PubMed  Google Scholar 

  3. APA (1987) DSM-IIIR. Diagnostic, statistical manual of psychiatric disorders. 3rd revised edn., American Psychiatric Association Press, Washington

    Google Scholar 

  4. Bartko JJ, Carpenter WT Jr. (1976) On the methods and theory of reliability. J Nerv Ment Dis 163:307–319

    Article  PubMed  CAS  Google Scholar 

  5. Castle D, Sham P, Murray R (1998) Differences in distribution of ages of onset in males and females with schizophrenia. Schizophr Res 33:179–183

    Article  PubMed  CAS  Google Scholar 

  6. Chaves AC, Seeman MV (2006) Sex selection bias in schizophrenia antipsychotic trials. J Clin Psychopharmacol 26:489–494

    Article  PubMed  Google Scholar 

  7. Conus P, Cotton S, Schimmelmann BG, McGorry P, Lambert M (2007) The first-episode psychosis outcome study: premorbid and baseline characteristics of an epidemiological cohort of 661 first-episode psychosis patients. Early interv psychiatry 1:191–200

    Article  Google Scholar 

  8. Davis JA, Goldstein MJ, Nuechterlein KH (1996) Gender differences in family attitudes about schizophrenia. Psychol Med 26:689–696

    PubMed  CAS  Google Scholar 

  9. Friis S, Melle I, Larsen TK, Haahr U, Johannessen JO, Simonsen E, Opjordsmoen S, Vaglum P, McGlashan TH (2004) Does duration of untreated psychosis bias study samples of first-episode psychosis? Acta Psychiatr Scand 110:286–291

    Article  PubMed  CAS  Google Scholar 

  10. Gilbody SM, House AO, Sheldon TA (2002) Outcomes research in mental health. Systematic review. Br J Psychiatry 181:8–16

    Article  PubMed  Google Scholar 

  11. Halbreich U, Kahn LS (2003) Hormonal aspects of schizophrenia: an overview. Psychoneuroendocrinology 28(suppl 2):1–16

    CAS  Google Scholar 

  12. Häfner H, Riecher A, Maurer K, Löffler W, Munk-Jørgensen P, Strömgren E (1989) How does gender influence age at first hospitalization for schizophrenia? A transnational case register study. Psychological Med 19:903–918

    Article  Google Scholar 

  13. Häfner H (2003) Gender differences in schizophrenia. Psychoneuroendocrinology 28(suppl 2):17–54

    Article  PubMed  Google Scholar 

  14. Høye A, Rezvy G, Hansen V, Olstad R (2006) The effect of gender in diagnosing early schizophrenia. Soc Psychiatry Psychiatr Epidemiol 41:549–555

    Article  PubMed  Google Scholar 

  15. Kay SR, Fiszbein A, Opler LA (1987) The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophr Bull 13:261–276

    PubMed  CAS  Google Scholar 

  16. Larsen TK, Friis S, Haahr U et al (2001) Early detection and intervention in first-episode schizophrenia: a critical review. Acta Psychiatr Scand 103:323–334

    Article  PubMed  CAS  Google Scholar 

  17. Lebowitz BD, Pearson JL (2000) Intervention research in psychosis: prevention trials. Schizophr Bull 26:543–549

    PubMed  CAS  Google Scholar 

  18. Leung A, Chue P (2000) Sex differences in schizophrenia, a review of the literature. Acta Psychiatr Scand suppl 401:3–38

    Article  PubMed  CAS  Google Scholar 

  19. Mc Evoy JP, Lieberman JA, Scott Stroup T, Davis SM, Meltzer HY, Rosenheck RA, Swartz MS, Perkins DO, Keefe RSE, Davis CE, Severe J, Hsiao JK (2006) Effectiveness of Clozapine versus Olanzapine, Quetiapine and Risperidone in patients with chronic Schizophrenia. Who did not respond to prior atypical treatment. Am J Psychiatry 163:600–610

    Google Scholar 

  20. McEvoy JP, Meyer JM, Goff DC, Nasrallah HA, Davis SM, Sullivan L, Meltzer HY, Hsiao J, Scott Stroup T, Lieberman JA (2005) Prevalence of the metabolic syndrome in patients with schizophrenia: baseline results form the clinical antipsychotic trial of intervention effectiveness (CATIE) schizophrenia trial and comparison with national estimates from NHANES III. Schizophr Res 80:19–32

    Article  PubMed  Google Scholar 

  21. McGrath JJ (2006) Variations in the incidence of schizophrenia: data versus dogma. Schizophr Bull 32:195–197

    Article  PubMed  Google Scholar 

  22. McGuffin P, Farmer A, Harvey I (1991) A polydiagnostical application of operational criteria in studies of psychotic illness. Arch Gen psychiatry 48:764–771

    PubMed  CAS  Google Scholar 

  23. Müller MJ (2007) Gender-specific associations of depression with positive and negative symptoms in acute schizophrenia. Prog Neuropsychopharmacol Biol psychiatry 31:1095–1100

    Article  PubMed  Google Scholar 

  24. Norman MGR, Malla AK, Manchanda R (2007) Delay in treatment for psychosis. Soc Psychiatr Epidemiol 42:507–512

    Article  Google Scholar 

  25. Preston NJ, Orr KG, Date R, Nolan L, Castle DJ (2002) Gender differences in premorbid adjustment of patients with first episode psychosis. Schizophr Res 55:285–290

    Article  PubMed  Google Scholar 

  26. Riecher-Rössler A, Häfner H (2000) Gender aspects in schizophrenia: bridging the border between social and biological psychiatry. Acta Psychiatr Scand 102(suppl 407):58–62

    Article  Google Scholar 

  27. Rosenbaum B, Valbak K, Harder S, Knudsen P, Køster A, Lajer M, Lindhardt A, winther G, Petersen L, Jørgensen P, Nordentoft M, Andreassen AH (2005) The Danish national schizophrenia project: prospective, comparative, longitudinal treatment study of first-episode psychosis. Br J Psychiatry 186:394–399

    Article  PubMed  Google Scholar 

  28. Roy MA, Maziade M, Labbé A, Mérette C (2001) Male gender is associated with deficit schizophrenia: a meta-analysis. Schizophr Res 47:141–147

    Article  PubMed  CAS  Google Scholar 

  29. Satajovic M, Jenkins JH, Strauss ME, Butt ZA, Carpenter E (2005) Gender identity and implications for recovery among men and women with schizophrenia. Psychiatr Serv 56:96–98

    Article  Google Scholar 

  30. Seeman MV (2004) Gender differences in the prescribing of antipsychotic drugs. Am J Psychiatry 161:1324–1333

    Article  PubMed  Google Scholar 

  31. Simonsen E, Friis S, Haahr U, Johannessen JO, Larsen TK, Melle I, Opjordsmoen S, Rund BR, Vaglum P, McGlashan T (2007) Clinical epidemiologic first-episode psychosis. 1 year outcome and predictors. Acta Psychiatr Scand 116:54–61

    Article  PubMed  CAS  Google Scholar 

  32. Strauss JS, Carpenter WT Jr. (1974) The prediction of outcome in schizophrenia II: relationships between prediction and outcome variables. Arch Gen Psychiatry 31:37–42

    PubMed  CAS  Google Scholar 

  33. Strauss JS, Carpenter WT (1977) Prediction of outcome in schizophrenia III: five-year outcome and its predictors. Arch Gen Psychiatry 34:159–163

    PubMed  CAS  Google Scholar 

  34. Szymansky S, Liberman JA, Alvir JM, Mayerhoff D, Loebel A, Geisler S, Chakos M, Koreen A, Jody D, Kane J, Woerner M, Cooper T (1995) Gender differences in onset of illness, treatment response, course and biological indexes in first-episode schizophrenic patients. Am J Psychiatry 152:698–703

    Google Scholar 

  35. Thorup A, Waltoft BL, Pedersen CM, Mortensen PB, Nordentoft M (2007) Young males have a higher risk of developing schizophrenia: a Danish register study. Psychological Medicine 37:1–6

    Google Scholar 

  36. Usall J, Haro JM, Ochoa S, Marquez M, Araya S (2002) Influence on gender on social outcome in schizophrenia. Acta Psychiatr Scand 106:337–342

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgment

The authors thank the following participating centres: Broenderslev Psychiatric Hospital; Psychiatric Unit Herning; The Psychiatric Hospital in Aarhus; The Psychiatric Hospital of Middelfart; Psychiatric Hospital Nykoebing Sjaelland; Psychiatric Hospital Fjorden Roskilde; Slagelse Department of Psychiatry; Holbaek Hospital Department of Child and Adolescence Psychiatry; Sct.Hans Hospital Department U7, Dianalund Psychiatric Hospital; Psychiatric Centre Glostrup; Bispebjerg Hospital Psychiatric department U; Frederiksborg County Hospital Psychiatric Department Hilleroed.

A six years grant from The Danish Ministry of Health has made it possible to carry out the project. Involved hospitals and centres have contributed financially as well.

Author information

Authors and Affiliations

  1. Center of Psychiatry at Rigshospitalet, University of Copenhagen, Faculty of Health Sciences, Borgmester Jensens Alle, 2100, Copenhagen, Denmark

    Anne Køster MD & Anne Lindhardt MD

  2. Psychiatric Hospital Augustenborg, Augustenborg, Denmark

    Matilde Lajer MD

  3. Centre of Psychiatry, Glostrup, University of Copenhagen, Faculty of Health Sciences, Glostrup, Denmark

    Bent Rosenbaum MD, DMSci

Authors
  1. Anne Køster MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Matilde Lajer MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Anne Lindhardt MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Bent Rosenbaum MD, DMSci
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Anne Køster MD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Køster, A., Lajer, M., Lindhardt, A. et al. Gender differences in first episode psychosis. Soc Psychiat Epidemiol 43, 940–946 (2008). https://doi.org/10.1007/s00127-008-0384-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00127-008-0384-3

Keywords

Search

Navigation